Anesthetic management of a 9‐year‐old child undergoing resection of a tracheal tumor

Abstract

Primary tracheal tumors in children are rare. We report the anesthetic management of a 9-year-old child undergoing resection of a midtracheal tumor obstructing approximately 73% of the tracheal lumen. To prepare for any possible airway emergency during the induction and maintenance of anesthesia, we ascertained preoperatively that a mini-tracheotomy tube could be inserted at the distal portion of the tracheal lesion. Oxygenation and ventilation were adequately maintained throughout the period of anesthesia. Anesthetic management for tracheal tumor resection should reflect the location of the tumor and the degree of tracheal obstruction.

Anesthesia airway management for tracheal resection and reconstruction: a single-center case series

“…In our study, the levels of airway obstruction and the tracheal diameters of the 2 patients with intubation (patients 1 and 2) were 70% (6 mm) and 55% (8 mm). As demonstrated in a previous case report (7), the anesthesia plan for endotracheal intubation is suitable for patients with soft or mild tracheal stenosis. In our cases, the level of tracheal stenosis was below 75% with the unobstructed tracheal diameter beyond 5 mm, which could ensure sufficient space to intubate with the endotracheal tube.…”

“…Surgery may improve 5-year survival rates from 5% to 47% (5). However, anesthesia during upper airway surgery is challenging as both anesthesiologists and surgeons are focused on the airway, and maintaining ventilation during general anesthesia is difficult (6)(7)(8). If ventilation cannot be effectively established after induction of general anesthesia, the patient's life may be endangered (9).…”

Subacute airway obstruction from a tracheal mucosal flap

“…In the advent of complete airway obstruction, the options would involve removing the obstruction via bronchoscopy, or oxygenating the blood through other means. Femorofemoral bypass may be one of the few other options reported to be effective in such cases [7]. This would need to be anticipated before commencing the procedure in order for appropriate preparation to be made.…”

Achieving Successful Extubation and Cost-Effective Recovery Following Anesthetic Airway Management in Supracarinal Tracheal Reconstruction Surgeries: A Retrospective Analysis

“…If the tracheal obstruction was more than 75%, LMA placement with spontaneous ventilation was preferred [ 28 ]. If the obstruction was less than 75%, with an unobstructed tracheal diameter of more than 5 mm and soft or intratracheal mass not prone to bleeding or detachment, placement of small-size ETT was preferred [ 29 ].…”